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Click here or scroll down to respond to this candidateCandidate's Name
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PROFESSIONAL EXPERIENCE & ACHIEVEMENTSCABARRUS HEALTH ALLIANCE, KANNAPOLIS NC 2021 FINANCE DEPT.DATA ENTRY CLERKInputted information related to the companys patient scheduled for the COVID-19 vaccine appointments prepared and sorted documents for data entry checking to ensure that the information inputted is accurate.Resolving discrepancies in information inputted is complete in order that the data can be used by other departments for reference or reports.ORTHOCAROLINA BUSINESS SERVICE, CHARLOTTE, NC 2020ACCOUNT CUSTOMER SUPPORT IRead accounts in Centricity based on incoming call INQUIRES.Reviewed all pertinent information through Citrix (Allscripts insurance cards, dictation, and face sheets).Documented in centricity after each call received or made to the patients.Followed up on accounts using the billing tracking form.Sent inquires to Lead Staff by email on accounts that required management direction.Updated Primary and Secondary insurance when required.Processed payments in HealthPay24 Portal.Setup payment plans and auto drafts through HealthPay24 Portal.Updated demographics (name, address, or email information) in Centricity.PARALLON REVENUE CYCLE SOLUTIONS, CHARLOTTE, NC 2017 to 2019CLIENT REPRENSENTATIVE INSURANCE CHAStatus account and document all work performed in the company and client computer systems.Access accounts to determine the next appropriate course of action in line with company policies and procedures.Place outbound calls to insurance companies, guarantors, patients, doctors' offices and/or facilities and manage incoming calls as necessary utilizing proper customer service protocol.Process related correspondence from insurance companies and perform pertinent follow-up.Reconcile balances and payments between insurance companies and clients' computer systems.Escalate issues to Team Lead or Manager, as necessary.Status account and document all work performed in the company and client computer systems.Place outbound calls to insurance companies, guarantors, patients, doctors' offices and/or facilities and manage incoming calls as necessary utilizing proper customer service protocol.Follow current department policies and procedures.Post any denials received from insurance payors.Post adjustment requests and explanations timely as identified.Meet and exceed quantity benchmark targets as established by management.Accounts receivable, cash collections, review bad dept and follow up on accounts.Communicate daily with management on payor trends identified.Maintain complete and accurate follow up actions in Claim IQ DAR.Meet and exceed quantity benchmark targets as established by management.CAROLINAS HEALTHCARE SYSTEM, Charlotte, NC 2009PATIENT ACCOUNTING REPRESENTATIVE/PFS-MEDICAIDFollow up verbally and in writing on all third-party liability claims for accounts aged 30 days or more.Maintain assertive follow-up techniques and meet per hour collection targets.Respond to incoming correspondence referrals and telephone calls from internal and external sources.Assist in manual billing of claims when warranted by BCBS, Commercial Managed Care, Medicare, and Medicaid guidelines.Call insurance primary and secondary insurance carriers: BlueCross BlueShield, United Healthcare, Aetna, and Cigna including all Health Maintenance Organization (HMO) to ensure related information is obtained and documented in detail, tracked and available to access and quality review.Obtain patient insurance information ad determine eligibility and benefit information via payer website or telephone.Obtain pre-authorizations from appropriate payers for services performed.Verify all charges available for processing.Request additional information needed from medical records.is Assist in manual billing of claims when warranted by BCBS, Commercial Managed Care, Medicare, and Medicaid guidelinesCall insurance primary and secondary insurance carriers: BlueCross BlueShield, United Healthcare, Aetna, and Cigna including all Health Maintenance Organization (HMO) to ensure related information obtained and documented in detail, tracked and available to access and quality review.Obtain pre-authorizations from appropriate payers for services performed.EQUITABE LIFE INSURANCE, NEW YORK, NY 06/2001 - 12/2004DISBURSEMENT ACCOUNTING DEPT.EXPENSE ACCOUNTANTPrepared and distributed vendor checks and filed paid vouchers for on-site storage.Reviewed disbursement requested for expense reports for accuracy and appropriate authorized signatures.Made appropriate corrections on duplicate payments as needed.Provided voucher information as requested in a timely manner.PROFESSIONAL CREDENTIALSStudies - Strayer UniversityGraduatedStrayer UniversityCharlotte, NCMedical Reimbursement SpecialistCentral Piedmont Community CollegeBusiness Administrative CourseYork CollegeHigh School DiplomaEli Whitney High SchoolACHIEVEMENTSWachovia Awards "Shared Success Award" Teamwork RecognitionAdvance Coding CertificateCRSC-1 CertificateCertified Revenue Cycle SpecialistAAHAM American HealthcareAdministrative ManagementLevel II Re-CertificationLevel II CertificationCarolinas Healthcare UNCC Patient Account Representative/CertificateWachovia Awards Shared Success Award Teamwork RecognitionAccess Careers Certification Course |
